Opioid Dependence Treatment transfers and permit termination

Treatment termination

Prescribers need to notify the Department of Health when a patient’s permit for methadone or buprenorphine is terminated.

Potential reasons for a patient’s ODT permit termination include:

• transfer to another prescriber
• patient transferred to Department of Justice and Community Safety system
• patient did not commence treatment
• treatment incomplete (by mutual agreement between prescriber and patient)
• patient completed treatment
• deceased

The notification of termination of a methadone or buprenorphine permit is a requirement under the Drugs, Poisons and Controlled Substances Act 1981. The notification of termination may be submitted online via Online forms - drugs and poisons regulation or SafeScript.

When a patient receiving ODT is released from a correctional setting, the department must be notified using the Prison release notification form. This is a separate requirement and does not replace the usual notification of the patient’s transfer.

ODT transfers out of Victoria

It is possible for a Victorian medical practitioner or nurse practitioner to write a prescription for ODT to be dispensed in the Australian Capital Territory, New South Wales, Queensland and South Australia. However, interstate regulatory administrators require 2–3 weeks’ notice of a transfer.

In the Northern Territory, Tasmania and Western Australia, pharmacists may not dispense pharmacotherapy prescriptions issued by a prescriber in another state. If you need to transfer a patient, you must arrange a transfer.

Each Australian state and territory has its own regulatory requirements for ODT. Requirements and processes can change, so always check the current requirements for the destination jurisdiction before arranging a transfer.

Treatment transfers into Victoria

Victoria allows pharmacists to dispense prescriptions for opioid dependence treatment written by interstate prescribers however different guidelines apply for a patient depending on whether they are permanently or temporarily in Victoria. It is crucial for the prescriber and the pharmacist to liaise prior to the patient transfer into Victoria.

Prescribers or patients can contact DirectLine 1800 888 236 or 1800 888 236 to obtain contact details of the nearest available ODT-prescriber and approved ODT pharmacy.

The Victorian Department of Health cannot facilitate ODT patient transfers.

Authorisations for an interstate prescriber – requirements

An interstate prescriber may write an ODT prescription for a patient who is travelling to Victoria either temporarily or permanently.

A prescriber who does not practise in Victoria but is a registered health practitioner in Australia and listed on the AHPRA register, may issue a prescription for a Schedule 8 poison to be dispensed in Victoria.

Temporary transfers

An interstate prescriber does not require a Victorian permit for their prescription to be dispensed in Victoria, provided the prescription is not written in Victoria.

Before the patient travels to Victoria, the prescriber is responsible for:

• confirming that the pharmacist/ pharmacy can accept the patient at their pharmacy
• ensuring that all relevant transfer details are provided to the pharmacist.

A temporary transfer should be limited to up to 4 weeks of treatment, given the potential risks associated with the frequency of clinical review.

Permanent transfers

If a patient is moving to Victoria permanently, the patient should be treated by an ODT prescriber practising in Victoria. Before the patient travels to Victoria, the original prescriber is responsible for:

• confirming that the transferring prescriber and pharmacist can accept the patient to their practice/pharmacy
• ensuring that all relevant transfer details are provided to the prescriber and pharmacist.

Validating the prescription with the pharmacist

When an interstate ODT prescriber is intending to prescribe ODT for supervised dosing at a Victorian pharmacy, the prescriber should first make contact and provide the Victorian pharmacist with all relevant transfer details and ensure that the pharmacist is able to accept the patient at their pharmacy. Before the patient arrives in Victoria, the prescriber should forward copies of the following to the pharmacist:

• the prescription
• details of the previous dosing point
• any relevant transfer documents
• a certified photograph of the patient.

Providing this documentation will help the Victorian pharmacist verify the identity and transfer details when the patient presents to the pharmacy with all the original documents.

Victorian pharmacists are not obligated to check if a valid permit or authorisation exists interstate. However, the pharmacist may check to confirm with the relevant jurisdiction that the prescriber is approved to prescribe ODT.

The pharmacist is required under Victorian legislation to check SafeScript before supplying ODT on a prescription and must take all reasonable steps to verify that the prescription was written by the prescriber. This reiterates the importance of early and proper communication between the prescriber and the pharmacist.